A Descriptive Study of the Online Kratom Market, an Opioid Alternative

Objective: Examine the online industry for kratom (Mitragyna speciosa), a plant-based substance used by Americans as an opioid alternative, and provide context to the market amidst regulatory attempts by the Food and Drug Administration and numerous state legislatures. Methods: Using search results collected from the three most widely used search engines, 663 websites were identified selling kratom products to US consumers. The top 100 most visited online vendors were selected and the content of their website and social media profiles were coded for topics including location, payment and shipping options, age verification, health warnings and disclaimers, grassroots advocacy regarding upcoming state and federal regulations, and response to the recent kratom-linked Salmonella outbreak. Results: 25% of vendors made claims that kratom provided relief from opioid withdrawal. 81% of vendors featured a disclaimer that kratom is addictive, with 54% stating that the product is not FDA approved. Only 5% of vendors utilized effective age verification through confirming age on delivery or use of a third party online database. Enforcement of state and locality bans on the vendor's part varied by location; 65% vendors did not sell to Indiana whereas only 27% prohibited sales to Rhode Island. Conclusions: The kratom internet vendor industry (KIV) was found to have low adherence to US state-level restrictions on the products’ purchase. There is a high prevalence of health claims featured on vendor webpages that are discouraged by the Food and Drug Administration.Master of Science in Public Healt

Is the E-Liquid Industry Regulating Itself? A Look at E-Liquid Internet Vendors in the United States

INTRODUCTION: The objective of this study was to assess whether the nascent, but rapidly growing e-liquid industry prohibits Internet sales to minors and employs safety measures to prevent accidental poisonings. METHODS: A stratified simple random sample (n = 120) was selected from the target population (N = 1107) of US online vendors of e-liquid in July 2015. The vendors were stratified and subsequently oversampled by trade association membership and vendor popularity. Three minors aged 16 to 17, who were supervised by adult research staff, attempted to purchase e-liquid from the 120 online vendors using debit cards issued in their names. Measures included vendors' use of age verification, warning labels on e-liquid bottles, and child-resistant packaging. RESULTS: Statistically significant differences were observed by vendor popularity, but not by membership in a trade association. The differences by vendor popularity, however, occurred for measures that were limited to an age warning and list of ingredients. The most striking finding was the scant vendors (n = 4) who successfully prevented the sale of e-liquid to the minors. In contrast, 87.5% and 53.9% of the bottles contained child-resistant packaging and a health warning label, respectively. CONCLUSIONS: Irrespective of trade association membership or vendor popularity, online vendors of e-liquids are not taking the proper precautions in preventing sales to minors. The FDA's upcoming deeming rules on e-cigarette products should include explicit requirements for offline and online e-liquid vendors, particularly the use of effective age verification, warning labels, and child-resistant packaging. IMPLICATIONS: This study demonstrates that, in the absence of any current FDA regulation of e-liquid products, self-regulation among vendors is not effective in preventing product acquisition by minors. Lax oversight of the e-liquid industry may draw consumers to bypass current tobacco control restrictions implemented in face-to-face sales settings. As a consequence, there may be an increase in online sales to minors. Further regulation of the industry may increase the already prevalent use of child-resistant packaging, leading to fewer cases of accidental nicotine poisoning

New α-Aminophosphonates as Corrosion Inhibitors for Oil and Gas Pipelines Protection

The problem of corrosion of metal equipment is one of the most actual problems in oil industry. One of the methods to solve this problem is the development of new low-toxic, accessible and effective corrosion inhibitors. For this purpose, we carried out the synthesis of the new α-aminophosphonates based on syntanyl phosphites, formalin and diethanolamine according to the Kabachnik-Fields reaction. The resulting products are characterized by 1H, 31P, 13C NMR, IR and mass spectroscopy methods. The obtained compounds contain a long radical chain of industrial (poly)ethoxylated alcohol residue with different length of the hydroxyethyl fragment, as well as an active center containing O-P-C-N fragment, which impart them inhibitory properties toward corrosion processes. The anticorrosive activity of the new aminophosphonates was studied by gravimetric analysis method. In the article the effect of concentration, time and degree of ethoxylation of the hydrocarbon radical in alpha-aminophosphonates on the protective effect of inhibitors was studies. It was shown that the obtained aminophosphonates exhibit high values of the protective effect of steel in a highly mineralized medium containing 250 g/m3 СО2 and 200 g/m3 Н2S. The high value of the protective effect (82-85 %) at inhibitor concentration of 25 mg/l was found. The maximum protective effect at 50 mg/ml dosage of the inhibitor is 94.3 %, while there is a decrease of the corrosion rate (less than 0.04 mm/year)

New Sintanyl Phosphonates for Protection of Oil and Gas Pipelines from Steel Corrosion

Many corrosion inhibitors are economically disadvantageous or toxic to the environment. Additionally, there are certain requirements for corrosion inhibitors. Therefore, the development of new corrosion inhibitors is one of the important problems in the oil-producing and oil-refining industry. The purpose of this work is the synthesis of new corrosion inhibitors with high inhibitory activity, the establishment of the structure of the compounds obtained and the determination of the anti-corrosion effect with respect to aggressive media. This paper presents the results of research on the development of new iron corrosion inhibitors. New α-aminophosphonates were synthesized based on the Kabachnik-Fields reaction. Formalin, morpholine, phosphite containing residues of industrial non-ionic surfactants - syntanols as radicals were used as a raw material. The compounds obtained were isolated in high yield. The structure of the compounds obtained is established by modern methods of physico-chemical analysis. The protective effect of the compounds obtained was studied by a gravimetric method for 6, 24, 72 hour exposure and an inhibitor concentration of 10, 25, 50, 100 ppm. As an aggressive medium, a highly mineralized medium containing СО2 and Н2S was used in simulated formation water. The dynamics of changes in the protective effect of the resulting aminophosphonate from time to time, at dosages of 2.5-100 ppm, were studied using electrochemical analysis methods. The protective effect of syntanyl-O-ethyl- (N-morpholinyl) methylphosphonate obtained at 25 ppm and a shutter speed of 6 hours is 73-82%. The article shows that with increasing concentration, an increase in the protective effect is observed. The greatest protective (89,6) effect showed O-2- [2- [2- [2- [2- [2- [2- [2- [2- [2- (dodecyloxy) ethoxy] ethoxy] ethoxy] ethoxy ] ethoxy] ethoxy] ethoxy] ethoxy] ethoxy] ethyl-O-ethyl- (N-morpholinyl) methylphosphone at a dosage of 100 ppm

Cost-effectiveness of eculizumab and efgartigimod for the treatment of anti-acetylcholine receptor antibody-positive generalized myasthenia gravis.

BACKGROUND: Eculizumab and efgartigimod were approved to treat anti-acetylcholine receptor antibody-positive generalized myasthenia gravis (anti-AChR Ab-positive gMG). These relatively new biological treatments provide a more rapid onset of action and improved efficacy compared with conventional immunosuppressive treatments, but at a higher cost. OBJECTIVE: To assess the cost-effectiveness of eculizumab and, separately, efgartigimod, each added to conventional therapy vs conventional therapy alone, among patients with refractory anti-AChR Ab-positive gMG and those with anti-AChR Ab-positive gMG, respectively. METHODS: A Markov model with 4 health states was developed, evaluating costs and utility with a 4-week cycle length and lifetime time horizon from a health care system perspective and a modified societal perspective including productivity losses from patients and caregiver burden. Model inputs were informed by key clinical trials and relevant publications identified from targeted literature reviews, and drug costs were identified from Micromedex Red Book. Costs and outcomes were discounted at 3% per year. Incremental cost-effectiveness ratios (ICERs; cost per quality-adjusted life-year [QALY] gained) were calculated for each comparison. RESULTS: Among the corresponding populations, lifetime costs and QALYs, respectively, for eculizumab were $5,515,000 and 11.85, and for conventional therapy,$308,000 and 10.29, resulting in an ICER of $3,338,000/QALY gained. For efgartigimod, lifetime costs and QALYs, respectively, were$6,773,000 and 13.22, and for conventional therapy, $322,000 and 9.98, yielding an ICER of$1,987,000/QALY gained. After applying indirect costs in a modified societal perspective, the ICERs were reduced to $3,310,000/QALY gained for eculizumab and$1,959,000/QALY gained for efgartigimod. CONCLUSIONS: Eculizumab and efgartigimod are rapidly acting and effective treatments for myasthenia gravis. However, at their current price, both therapies greatly exceeded common cost-effectiveness thresholds, likely limiting patient access to these therapies

Influence of the Metal Surface Texture on the Possibility of Controlling the Phase Transition of Water Droplets in the Single-Phase Regime

We experimentally studied the influence of the texture of copper and steel surfaces on the possibility of controlling the phase transition of water droplets in the single-phase regime. The texture of metals was formed by polishing and grinding, which corresponded to the finishing treatment of heat transfer surfaces in cooling systems for energy-saturated equipment. The samples were studied by microscopy and profilometry. The texture was estimated by three-dimensional roughness parameters. It was found that, with a 2–2.5-fold increase in roughness, the wetting of copper deteriorates (the contact angle increases from 66° to 93°), whereas the wetting of steel improves (the contact angle decreases from 89° to 71°). It was experimentally proven that, among the two main factors that affect the spreading diameter (wetting and roughness), wetting is the most significant. A hypothesis was formulated regarding the reason for the increase in the contact angle of 7–10° and the drop in the decrease rate of the contact diameter during the transition from the pinning to the mixed stage of droplet evaporation. It was found that an increase in the surface area of 0.1% leads to an increase in the total droplet evaporation rate of 4–6.5%

Predictors of older adult gambler in representative sample: Implications for education, prevention and treatment

Abstract: Though rates of gambling among older adults appear to be increasing, few studies have examined the factors that distinguish older adult problem gamblers in a representative sample. This presentation will detail findings from a statewide, epidemiological survey using univariate and multinomial logistic regression. Among older adults (56-97; N=624), those with gambling problems were more likely to be African American or to have gambling friends and less likely to be divorced than all other older adult gamblers. Overall, older adult gamblers were more likely than young gamblers (18-35; N=714) to be white, divorced or separated, and undereducated and to report military service, owning a home, using tobacco, having a disability and less likely to play daily fantasy sports, live poker or to bet on sports. Compared to middle-aged adults (36-55; N+624), older adult gamblers were less likely to be Asian or Hispanic, to report drug usage, to play daily fantasy sports, trade high risk stocks or bet on sports, and more likely to report military service or home ownership. Across groups, older adults were underrepresented among those with the highest levels of problem gambling severity but were more likely than other gamblers to participate in multiple gambling activities. Implications: A greater understanding of older adult gamblers will assist in tailoring education, intervention, and treatment efforts to the unique needs and characteristics of this population, resulting in harm reduction and more robust prevention strategies